关键词: 肺炎, 重症监护病房, 通气机,机械, 康复护理

Abstract:

Objective: To explore the clinical effect of early multimodal rehabilitation therapy in patients with severe pneumonia receiving mechanical ventilation. Methods: A retrospective study was conducted. A total of 180 patients with severe pneumonia on mechanical ventilation admitted to the Department of Critical Care Medicine, Sanming First Hospital Affiliated to Fujian Medical University from May 2022 to August 2025 were enrolled. The patients were divided into observation group and control group according to rehabilitation regimens, with 90 cases in each group. The control group received sputum-expectoration, pneumatic compression therapy and conventional rehabilitation. The observation group was given early multimodal rehabilitation (physical therapy, respiratory training, nutritional support and metabolic regulation, psychological intervention and cognitive rehabilitation) within 24-48 hours after mechanical ventilation. The two groups were compared in terms of General Comfort Questionnaire (GCQ) score, Pittsburgh Sleep Quality Index (PSQI) at intensive care unit (ICU) discharge, duration of analgesic-sedative medication, duration of mechanical ventilation, length of ICU stay, incidences of complications including intensive care unit-acquired weakness (ICU-AW) and delirium, post-ICU syndrome (PICS), and mortality. Results: At ICU discharge, the GCQ score of the observation group was (82.4±2.7) points, which was significantly higher than (69.4±3.2) points of the control group; the PSQI score was (10.3±0.3) points, significantly lower than (14.2±0.4) points of the control group, with statistically significant differences (t=29.744, 81.798, both P<0.001). The duration of analgesic-sedative medication ((22.3±1.3) h), duration of mechanical ventilation ((46.3±1.3) h) and length of ICU stay ((8.4±2.3) d) in the observation group were all significantly shorter than those in the control group ((42.1±1.3) h, (68.4±1.3) h, (13.3±2.3) d respectively), with statistically significant differences (t=102.590, 114.200, 14.330, all P<0.001). The incidence of ICU-AW in the observation group was 13.3% (12/90), significantly lower than 36.7% (33/90) in the control group (χ²=13.067, P<0.001); the incidence of delirium was 6.7% (6/90), significantly lower than 16.7% (15/90) in the control group (χ²=4.367, P=0.037); the incidence of 48-hour ICU readmission was 3.3% (3/90), significantly lower than 16.7% (15/90) in the control group (χ²=8.889, P=0.003). The incidence of PICS in the control group was 53.3% (48/90), which was significantly higher than that in the observation group (33.3% (30/90))(χ²=7.330, P=0.007). Conclusion: For patients with severe pneumonia receiving mechanical ventilation, early multimodal rehabilitation therapy can improve patients’ comfort and sleep quality, shorten the duration of analgesic-sedative medication, mechanical ventilation and ICU stay, and reduce the incidence of complications, which possesses favorable clinical application value.

Key words: Pneumonia, Intensive care units, Ventilators, mechanical, Rehabilitation nursing